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Four years after raid, federal grand jury indicts five ex-WellCare executives

TAMPA — Four years after an FBI raid brought to light accusations of Medicaid fraud at WellCare, a federal grand jury indicted five of the company's former executives, authorities announced Wednesday.

All five men are charged with conspiracy to commit Medicaid fraud and making false statements. They are former CEO Todd S. Farha, 42, of Tampa; former general counsel Thaddeus Bereday, 45, of Tampa; former CFO Paul L. Behrens, 49, of Odessa; former vice president of Harmony Behavioral Health William Kale, 61, of Oldsmar; and former vice president of Medical Economics Peter E. Clay, 54, of Massachusetts.

The indictment says WellCare, based near Tampa, took Medicaid money from Florida's Agency for Health Care Administration with the understanding that if it did not use 80 percent of the funds allotted for behavioral health services, the difference was to be returned to the state.

But, prosecutors said, WellCare executives conspired to inflate what they actually spent to reduce the amount they had to return.

WellCare, which runs private Medicare and Medicaid plans, turned in $4 billion in sales in 2006 under Farha's leadership. But federal agents conducted an 18-month investigation that culminated in an October 2007 raid. WellCare stock shares plunged from $122 to $42 a share that year.

In January 2008, Farha, Behrens and Bereday were forced to resign. Farha was divested of more than $10 million in stock. Behrens and Bereday forfeited hundreds of thousands in salary.

Former employee Gregory West, who had worked under Clay, pleaded guilty in 2009 to participating in a scheme to defraud the Medicaid program.

The company paid $80 million in May 2009 and reached a civil settlement with the Department of Justice for $137 million in 2010. But whistle-blowers put profits of the alleged fraud between $400 million and $600 million.

Each defendant is charged with one count of conspiracy to commit health care fraud, four counts of health care fraud and of making false statements relating to health care matters. Clay is also facing two counts of making false statements to federal agents.

Each man faces up to 10 years in prison for each health care fraud count, and up to five years for the other charges.

Four years after raid, federal grand jury indicts five ex-WellCare executives 03/02/11 [Last modified: Wednesday, March 2, 2011 11:26pm]

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